Laminectomy/Facetectomy/Foraminotomy for Decompression (CPT 63047)

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Question:

I recently attended a coder’s meeting and the speaker said when doing a decompression laminectomy at L4-L5 (using 63047) that we should report two codes (63047 and 63048) because L4 is one level and L5 is another. I’ve been using one code when the procedure is performed at L4-L5. Have I been coding incorrectly?

Answer:

It sounds like you have been doing it the right way. To clarify, if the procedure is performed at L4-L5, meaning the inferior L4 lamina and superior L5 lamina are removed as well as a foraminotomy at L4-L5 to decompress the exiting nerve root, you will report only one CPT code (63047). To report a second code, 63048, the surgeon will need to remove more of the lamina at either L4 or L5 and do a foraminotomy with decompression of a different exiting nerve root such as at L3-L4 or L5-S1.